- Ocular histoplasmosis
- Angioid streaks
- Miscellanous – macroaneurysm, tumours, iatrogenic (surgical/laser), Valsalva retinopathy, DR.
Symptoms: Sudden painless loss of central vision with metamorphosia.
Investigation: OCT macula.
Prognosis factors for vision recovery:
- Volume (thickness and extent)
- Duration (within 1-2 weeks for intervention)
- Pneumatic displacement (100% 0.3ml C3F8) + tPA (50 micrograms/0.1ml)
- Anti VEGF
- PPV + subretinal tPA + anti VEGF + gas
- Macular translocation
Preparation guide for Alteplase (tPA) 50 micrograms in 0.1ml IVT injection:
- Use 10mg Actilyse
- Add 10ml water for injection (provided with Actilyse pack) to 10ml Actilyse vial –> 1mg/ml solution
- Shake vial to dissolve.
- Use 1ml syringe – draw up 0.5ml from reconstituted vial.
- Transfer to sterile vial.
- Use fresh 1ml syringe and withdraw 0.5ml water.
- Add the 0.5ml water into the 0.5ml reconstituted vial.
- Mix well –> 500 micrograms in 1ml solution.
- Administer 50 micrograms/0.1ml as IVT using a fresh 1ml syringe.